Descriptive epidemiology of sports injury and illness during the Rio 2016 Olympic Games: A prospective cohort study for Korean team

Abstract

This study aimed to analyze the characteristics of injuries and illnesses that occurred during the Rio 2016 Olympic Games for Korean team by using a prospective cohort design. In total, 204 Korean athletes competed in 24 sporting events during the Olympic Games. The entire medical staff of the Korean team recorded injuries and illnesses on a daily basis that occurred during training and competition using the International Olympic Committee injury and illness surveillance system. During the Olympic Games, 308 injuries and 73 illnesses were reported; the incidence was 150.9 injuries and 35.8 illnesses per 100 athletes. In addition, 56.3% and 24.0% of all athletes sustained at least one injury or illness, respectively. The highest rate of injuries was observed in boxing and wrestling, whereas the highest rate of illnesses was seen in boxing and swimming. Twelve percent of all injuries resulted in absenteeism from training or competition for at least 1 day. Of all infections, 75.9% occurred in the respiratory tract. In addition, 2.7% of all illnesses prevented athletes performing their sport for 1 day. These results may be used to further analyze mechanisms of injury and their risk factors in Olympic sports to develop effective preventive strategies for athletes.

Keywords

Injury surveillance International Olympic Committee sports medicine

Introduction

Protecting the health of athletes by preventing injuries is a clearly articulated objective of the international sports federations (IFs), the International Olympic Committee (IOC), and the National Olympic Committees (NOCs), including the Korean Olympic Committee (KOC).^1–3 According to van Mechenlen et al.,⁴ the first step of the four-stage model to implement effective injury-prevention strategies for athletes is conducting an epidemiologic study of the injuries. Through systematic injury and illness surveillance monitors, an evidence-based understanding of incidence rates, characteristics, risk factors and associated mechanisms of injuries, and illnesses provides valuable information to reduce the occurrence of injuries⁵ and more importantly, informs the development and assessment of prevention measures.⁶

In a previous study, authors reported that in the 1981 Junior Olympic Games (OGs), medical coverage was initially provided to 1800 adolescent athletes by 21 medical staff.⁷ The Fédération International de Football Association (FIFA) started to systematically document all injuries incurred during competitions in the 1998 FIFA World Cup;⁸ other IFs followed FIFA’s Medical Assessment and Research Centre.⁵ An injury-surveillance system was implemented in all team sports during the 2004 OGs to compare the incidence and characteristics of injuries in different types of sports.⁹ Based on these experiences, an injury surveillance system for multi-sport events was developed by experts and the IOC, and was used, for the first time, during the Beijing 2008 OGs.¹⁰ Epidemiologic studies of sports injury and illness have since been conducted using injury-surveillance systems, not only during multi-sports events such as the OGs and Youth OGs,^5,6,10–13 but also single-sport events.^14–19

The KOC was established in 1946 and became an IOC member country at the 41^st IOC Session in 1947, and Korea first participated in the London Games in July 1948.²⁰ The KOC, just like other NOCs, emphasized protecting the health of those participating in sports.²⁰ In particular, the KOC has three national training centers that provide sports medicine and scientific services for elite-level athletes in various sports.²⁰ Furthermore, various epidemiologic studies of sports injuries have been conducted in a diverse population in Korea.^21–29

Major sporting events provide an ideal environment to conduct research, including systematic injury and illness surveillance, because it can be done in a relatively homogenous group of people in a high-standard environment.⁵ To our knowledge unfortunately, most epidemiologic studies evaluating Korean athletes’ sports injury were implemented for nonspecific periods of time in specific sport event by using their separate methods.^24,26–29 Therefore, systematic injury and illness surveillance in the skill-level of Korean athletes performing various sport events during a multi-sport events period should be implemented.

Purpose of study

Considering the current and previous research, the aim of this study was to analyze the injuries and illnesses that occurred during the 2016 OGs, with the long-term aim to establish additional initiatives protect the athletes’ health.

Methodology

Study design

We conducted a prospective cohort study over 10 pre-competition days and 17 competition days of the 2016 OGs in Rio de Janeiro, Brazil. A few days before departing for the Games, 25 medical staff (2 physicians, 7 physiotherapist, and 16 athletic trainers) from the Korean Olympic team (KOT) had a meeting to account for and discuss the study procedures. The medical staff was required to record a daily report based on IOC injury and illness surveillance system, which has been used during other OGs since 2008^5,6,10–13 and to send it to data management via e-mail.

Data reduction

The medical clinic of KOT in the Olympic Village provided diagnostic and therapeutic services including physical examinations, diagnostic ultrasonography, pharmacy, physiotherapy, taping, and bracing. Whenever possible, the medical staff accompanied athletes to training and competitions. In the case where the required level of medical services for an injury or illness extended beyond the abilities of the Korean medical clinic, injured and/or ill athletes were accompanied by a KOT medical staff to the Olympic Village Polyclinic or regional medical facilities for additional examination. This was recorded in detail along with the daily report.

Definition of injury and illness

According to the methods of the IOC injury and illness surveillance,^5, ^{6,10–13,30,31} an injury was defined as musculoskeletal symptoms or concussions that were newly incurred or recurred for those with a previous history during competition or training. An illness was defined as any physical concern unrelated to injury, that was newly incurred during the competition or training. Patients with an injury or illness received medical attention, such as advice or treatment, regardless of the absenteeism from competition or training. In cases where a single incident caused multiple types of injuries or affected multiple body parts, or if different body parts were affected by illnesses, we recorded only the most severe diagnosis.^11,12

Injury and illness report form

The daily report was identical to the one used in previous OGs, and required the following information: athlete’s accreditation code, sport discipline/event, date, time, diagnosis, competition/training, involved body part, injury type, mechanism or cause, and estimated time loss.^5,6,10–13 Similarly, the illness daily report included the athlete’s accreditation code, sport discipline/event, date, time, diagnosis, competition/training, affected system, main symptom(s), and cause of illness, as well as an estimate of time loss. Time loss injury or illness was defined as a musculoskeletal condition or a physical concern that resulted in time lost from participating in training or competitions. Instructions were provided in Korean to all medical staff members from KOT, so that they would completely the report correctly every day.

Confidentiality and ethical approval

The accreditation codes were only recorded and used to avoid duplicate reporting from all medical staff members and provide information on age, sex, and sport. All information was kept strictly confidential and anonymized in our database at the end of the OGs.

Data analysis

The athlete’s individual incidence of injury or illness was expressed as injuries/illnesses per 100 athletes. All data were evaluated using Excel (Microsoft, Redmond, WA) and SPSS 20.0 (SPSS Inc., Chicago, IL). Descriptive data are presented as frequencies and percentages. A χ² test was used to compare the frequency of injuries/illnesses between sexes. Statistical significance was defined as p < 0.05.

Results

Overall, 204 Korean athletes (101 women, 103 men) competed in 24 of 28 Olympic Sports during the Rio 2016 OGs. There were 308 injuries and 73 illnesses recorded within the KOT, resulting in an incidence of 150.9 injuries (95% confidence intervals: 125.41–198.44) and 35.8 illnesses (95% confidence intervals: 26.55–49.03) per 100 athletes. Of all the Korean athletes participated in Rio OGs, 56.3% (n = 115) and 24.0% (n = 49) sustained at least one injury or illness, respectively. Seventy-four (36.3%) and 18 (8.8%) athletes sustained multiple injuries (2–9 injuries per athlete) and illnesses (2–3 illnesses per athlete), respectively. No significant difference in the frequency of injuries was found between women and men (χ²= 0.748, p = 0.387). However, the frequency of illnesses was significantly higher in women (33.7%, 34 athletes) than in men (14.6%, 15 athletes) (χ²= 10.194, p = 0.001) (Tables 1 and 2). Eleven patients (16 injuries) were transferred to the policlinic or a regional medical facilities for additional examination, including 1 badminton player, 1 cyclist, 1 soccer player, 2 gymnasts, 2 handball players, 3 judo players, and 1 wrestler; none of the patients with illnesses required further examination.

Table 1.

Frequencies (percentages) of overall injuries, injuries leading to time loss (≥1 or >7 days of estimated absence), competition and training injuries and overall illnesses in the Olympic sports.

Olympic sport	Athletes (n)	Injuries					All illnesses^a
Olympic sport	Athletes (n)	All^a	≥1 day^b	>7 days^b	Competition^b	Training^b	All illnesses^a
Archery	6	1 (0.3)	0 (0.0)	0 (0.0)	0 (0.0)	1 (100.0)	1 (1.4)
Athletics	15	6 (1.9)	0 (0.0)	0 (0.0)	0 (0.0)	6 (100.0)	4 (5.5)
Badminton	14	18 (5.8)	1 (5.6)	0 (0.0)	7 (38.9)	11 (61.1)	3 (4.1)
Boxing	1	6 (1.9)	0 (0.0)	0 (0.0)	2 (33.3)	4 (66.7)	2 (2.7)
Canoe	2	4 (1.3)	0 (0.0)	0 (0.0)	1 (25.0)	3 (75.0)	1 (1.4)
Cycling	8	9 (2.9)	5 (55.6)	0 (0.0)	2 (22.2)	7 (77.8)	2 (2.7)
Equestrian	1	0 (0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Fencing	14	33 (10.7)	4 (12.1)	1 (3.0)	8 (24.2)	25 (75.8)	9 (12.3)
Football	18	20 (6.5)	1 (5.0)	0 (0.0)	13 (65.0)	7 (35.0)	0 (0.0)
Golf	6	3 (1.0)	0 (0.0)	0 (0.0)	0 (0.0)	3 (100)	0 (0.0)
Gymnastics	7	9 (2.9)	4 (44.4)	2 (22.2)	2 (22.2)	7 (77.8)	3 (4.1)
Handball	14	39 (12.7)	8 (20.5)	1 (2.6)	8 (20.5)	31 (79.5)	6 (8.2)
Hockey	16	28 (9.1)	0 (0.0)	0 (0.0)	19 (67.9)	9 (32.1)	9 (12.3)
Judo	12	14 (4.5)	3 (21.4)	1 (7.1)	8 (57.1)	6 (42.9)	3 (4.1)
Modern pentathlon	3	2 (0.6)	0 (0.0)	0 (0.0)	2 (100)	0 (0.0)	0 (0.0)
Rowing	2	2 (0.6)	0 (0.0)	0 (0.0)	1 (50.0)	1 (50.0)	1 (1.4)
Sailing	4	7 (2.3)	1 (14.3)	0 (0.0)	6 (85.7)	1 (14.3)	1 (1.4)
Shooting	17	3 (1.0)	0 (0.0)	0 (0.0)	1 (33.3)	2 (66.7)	3 (4.1)
Swimming	9	11 (3.6)	0 (0.0)	0 (0.0)	1 (9.1)	10 (90.9)	12 (16.4)
Table tennis	6	8 (2.6)	0 (0.0)	0 (0.0)	1 (12.5)	7 (87.5)	2 (2.7)
Taekwondo	5	19 (6.2)	1 (5.3)	0 (0.0)	8 (42.1)	11 (57.9)	0 (0.0)
Volleyball	12	23 (7.5)	5 (21.7)	0 (0.0)	9 (39.1)	14 (60.9)	7 (9.6)
Weightlifting	7	15 (4.9)	2 (13.3)	0 (0.0)	0 (0.0)	15 (100)	2 (2.7)
Wrestling	5	28 (9.1)	2 (7.1)	0 (0.0)	12 (42.9)	16 (57.1)	2 (2.7)
Total	204	308 (100)	37 (12.0)	5 (1.6)	111 (36.0)	197 (64.0)	73 (100)

Values are presented as frequencies and percentages.

Percentages of total injuries or illnesses.

Percentages of all injuries by each sport.

Table 2.

Frequencies (percentages) of overall injuries, injuries leading to time loss (≥1 day of estimated absence) and overall illnesses in female and male athletes in the Olympic sports.

	Female athletes				Male athletes
Olympic sport	n	Injuries		All illnesses^a	n	Injuries		All illnesses^a
Olympic sport	n	All^a	≥1 day^b	All illnesses^a	n	All^a	≥1 day^b	All illnesses^a
Archery	3	1 (0.6)	0 (0.0)	1 (2.0)	3	0 (0.0)	0 (0.0)	0 (0.0)
Athletics	5	2 (1.3)	0 (0.0)	0 (0.0)	10	4 (2.7)	0 (0.0)	4 (17.4)
Badminton	7	9 (5.7)	0 (0.0)	0 (0.0)	7	9 (6.0)	1 (11.1)	3 (13.0)
Boxing	–	–	–	–	1	6 (4.0)	0 (0.0)	2 (8.7)
Canoe	–	–	–	–	2	4 (2.7)	0 (0.0)	1 (4.3)
Cycling	2	0 (0.0)	0 (0.0)	1 (2.0)	6	9 (6.0)	5 (55.6)	1 (4.3)
Equestrian	–	–	–	–	1	0 (0.0)	0 (0.0)	0 (0.0)
Fencing	8	20 (12.7)	0 (0.0)	8 (16.0)	6	13 (8.7)	4 (30.8)	1 (4.3)
Football	–	–	–	–	18	20 (13.3)	1 (5.0)	0 (0.0)
Golf	4	3 (1.9)	0 (0.0)	0 (0.0)	2	0 (0.0)	0 (0.0)	0 (0.0)
Gymnastics	2	5 (3.2)	4 (80.0)	3 (6.0)	5	4 (2.7)	0 (0.0)	0 (0.0)
Handball	14	39 (24.7)	8 (20.5)	6 (12.0)	–	–	–	–
Hockey	16	28 (17.7)	0 (0.0)	9 (18.0)	–	–	–	–
Judo	5	3 (1.9)	1 (33.3)	3 (6.0)	7	11 (7.3)	2 (18.2)	0 (0.0)
Modern pentathlon	1	0 (0.0)	0 (0.0)	0 (0.0)	2	2 (1.3)	0 (0.0)	0 (0.0)
Rowing	1	0 (0.0)	0 (0.0)	1 (2.0)	1	2 (1.3)	0 (0.0)	0 (0.0)
Sailing	–	–	–	–	4	7 (4.7)	1 (14.3)	1 (4.3)
Shooting	8	1 (0.6)	0 (0.0)	1 (2.0)	9	2 (1.3)	0 (0.0)	2 (8.7)
Swimming	5	7 (4.4)	0 (0.0)	7 (14.0)	4	4 (2.7)	0 (0.0)	5 (21.7)
Table tennis	3	7 (4.4)	0 (0.0)	2 (4.0)	3	1 (0.7)	0 (0.0)	0 (0.0)
Taekwondo	2	7 (4.4)	0 (0.0)	0 (0.0)	3	12 (8.0)	1 (8.3)	0 (0.0)
Volleyball	12	23 (14.6)	5 (21.7)	7 (14.0)	–	–	–	–
Weightlifting	3	3 (1.9)	1 (33.3)	1 (2.0)	4	12 (8.0)	1 (8.3)	1 (4.3)
Wrestling	–	–	–	–	5	28 (18.7)	2 (7.1)	2 (8.7)
Total	101	158 (100)	19 (12.0)	50 (100)	103	150 (100)	18 (12.0)	23 (100)

Values are presented as frequencies and percentages.

Percentages of total injuries or illnesses.

Percentages of all injuries by each sport.

Injury characteristics

The incidence of injury was the highest in boxing (600.0 injuries per 100 athletes), wrestling (500.0), taekwondo (380.0), handball (278.6), and fencing (235.7). Only one male boxer who entered to compete for KOT had six different injury types in each of the six body parts by different causes and mechanisms. In addition, 74.4% of all injuries were newly incurred and 25.6% recurring. Sixty-four percent of the injuries occurred during training, while 36.0% happened during competition. However, 13 of 20 injuries sustained by soccer players, and 19 of 28 injuries from hockey players occurred in competition. The ankle (13.0%, 40 injuries), lower back (11.7%, 36 injuries), knee (11.4%, 35 injuries), and thigh (9.7%, 30 injuries) were the four most commonly injured body parts among athletes; 51.9% and 24.0% occurred in lower extremities and upper extremities, respectively. One injury to the face was reported in soccer, and 2 injuries to the head in gymnastics, including 1 concussion. The most frequently reported injury types were strain (24.0%, 74 injuries), sprain (21.8%, 67 injuries), muscle cramp (21.1%, 65 injuries), and tendinopathy (16.9%, 52 injuries); 36.5% of tendinopathy, and 28.4% of strains, and 22.4% of sprains were recurring. The most commonly mentioned injury causes were overuse (41.6%, 128 injuries), noncontact (25.6%, 79 injuries), and unknown injuries (13.3%, 41 injuries). Thirty-seven (12.0%) of all injuries led to absenteeism from training or competition, while five injuries were expected to lead to > 7 days absenteeism from sport. In addition, 32.4% (12 injuries) of all time-loss injuries incurred during competitions, while 67.6% occurred in training. Table 3 shows the characteristics of time-loss injuries depending on each sport.

Table 3.

The number of injuries leading to time loss (≥1 day of estimated absence) characteristics by each sport.

	Badminton (n = 14)	Cycling (n = 8)	Fencing (n = 14)	Football (n = 18)	Gymnastics (n = 7)	Handball (n = 14)	Judo (n = 12)	Sailing (n = 4)	Taekwondo (n = 5)	Volleyball (n = 12)	Weightlifting (n = 7)	Wrestling (n = 5)
Number of injuries	1	5	4	1	4	8	3	1	1	5	2	2
Injury type
Concussion		5			1
Fracture					2
Dislocation						1
Tendon rupture												1
Sprain				1		3	3			2	1	1
Strain			1			1		1	1	1	1
Fasciitis			1			1
Tendinopathy	1					1				2
Muscle cramp			2			1
Contusion					1
Injury cause
Contact		5		1	2	2	2	1		2		2
Noncontact					2	2					1
Overuse	1		4			2	1		1	2	1
Unknown						2				1
Injury history
Newly incurrent	1	5	3	1	4	8	2	1		5	1	2
Recurrent			1				1		1		1
Injury occurrence
Competitions		2	2			3	2			1		2
Trainings	1	3	2	1	4	5	1	1	1	4	2

Values are presented as frequencies.

No time-loss injuries sustained by the following sports: Archery (n = 6), Athletics (n = 15), Boxing (n = 1), Canoe (n = 2), Equestrian (n = 1), Golf (n = 6), Hockey (n = 16), Modern pentathlon (n = 3), Rowing (n = 2), Shooting (n = 17), Swimming (n = 9), Table tennis (n = 6).

Illness characteristics

Illness incidence was highest in boxing (200.0 illnesses per 100 athletes), swimming (133.3), fencing (64.3), and volleyball (58.3). Only one boxer who entered to compete for KOT had two different diagnoses in two affected systems with different main symptoms. Infection (39.7%, 29 illnesses) was the most common cause of illness. Almost all of the infections occurred in the respiratory tract (75.9%, 22 illnesses); three cases (10.3%) of urogenital infection and two cases (6.9%) of gastrointestinal and dermatological infections were reported, respectively. The most frequently reported symptoms were pain (38.4%, 28 illnesses), congestion (13.7%, 10 illnesses), and rash and nausea (9.6%, 7 illnesses, respectively). Two cases (2.7%), including one patient with a headache and the other, dizziness, prevented the athlete from training or competing for a day.

Discussion

Injury rate compared with other multi-event games

For the KOT, the overall rate (56.3%) of injury in the Rio OGs was even higher than those in Beijing, Vancouver, London, and Sochi (range, 10–12%).^5,6,10,11 In particular, the incidence of injury (150.9 injuries per 100 athletes) in KOT was different, compared with that of the Beijing and London OGs (9.61 injuries and 12.88 injuries per 100 athletes, respectively).^10,11 A higher injury rate was seen in athletes from the Beijing OGs competing in football, taekwondo, and hockey; approximately 20–32% of registered athletes were affected in each sport.¹⁰ In the London OGs, a higher risk for injury was found in athletes competing in taekwondo, football, and BMX (range, 31–39%).¹¹ This study showed that injury incidence was highest in boxing, followed by wrestling, and taekwondo. As mentioned above, only one male boxer in KOT participated in the Rio OGs, and he had six different types of injuries in each of the six body part from different causes and mechanisms of injury. Subtle changes in the number of injuries or illnesses can influence prevalence rates to a larger degree in study cohorts with a small sample size.³¹ It may relate to the highest incidence of injuries in boxing among other sporting events. Even the data collection period used in this study, including the 10 pre-competition days was slightly longer than the Rio OGs period and more detailed data were collected by the KOT medical staff. In a previous study, researchers mentioned that expressing the total number of injuries/illnesses per registered athletes for each discipline is highly relevant to an absolute injury risk such as injuries per run/matches.⁵ However, if further studies should use an injury per 100 or 1000 athlete-exposures (AEs) as an injury risk, they would provide valuable information on injury characteristics of each sport event.

In the 2002 Asian Games, an injury rate (injuries per 1 athlete of each event) of Korean athletes was higher in rugby, karate, and gymnastics.²¹ An incidence rate (injuries per 1000 AEs) of acute injuries occurred during 2010 Asian Games was higher in athletics, boxing, and taekwondo.²⁵ Also, an incidence rate (injuries per 1000 AEs) of injuries newly incurred for Korean female and male athletes during the training period in preparation for OGs was highest in hockey and boxing, respectively.²⁴ Even though the Korean athletes had a high skill-level, there was a difference in the incidence of injuries among various studies, which shows the need of more comprehensive and long-term data reporting by physicians trained well as injury and illness recorders by IFs of each sport.

Severity, location, type, and cause of injuries

Minor injuries and illnesses with no or minimal time-loss can affect athletes’ performance, and even a time-loss injury or illness may prevent Olympic athletes from reaching their life-time achievement.¹¹ In the Rio OGs, Korean athletes’ time-loss injury account for 12.0% of all injuries, which was estimated to include time-loss for at least one day from training or competition, and five injuries of all time-loss injuries were estimated to have > 7 days absent from sport. The rate of time-loss injuries in Korean athletes during the Rio OGs is remarkably lower than that of the Beijing Games (49.6%) and London Games (35.0%). Approximately 70% of time-loss injuries occurred during training, contrasting findings of previous surveillance studies that the injury rate is higher in competition than in training.^10,11 It might indicate that qualification criteria for Korean athletes participating in OGs should become more sensitive.

The most prevalent injury type and body parts that occurred injuries were the strain (24.0%)/sprain (21.8%) and lower extremities (51.9%), respectively. In the 2008 OGs, the most prevalent diagnoses were ankle sprains (7.3%) and thigh strain (6.8%), and 54.2% affected the lower extremity, especially thigh (13.3%) and knee (12.1%).¹⁰ During the 2010 Games for Korean athletes, the lateral ankle ligament sprain (9.7%) and the chronic ankle sprain/instability (11.7%) were most diagnosed in acute injuries and chronic injuries, respectively.²⁵ In 2002 Games for Korean athletes, the most prevalent injuries occurred in lower extremities, and injuries related to muscles.²¹ Our findings were in agreement with previous studies on sports injuries. Only one concussion was recorded from gymnastics in this study, and she was 17 years old. These findings may be because athletes performing sport events in Summer OGs are exposed to relatively low speeds, compared with those in Winter OGs.¹¹ Because the risk for concussions is a recurring concern in certain sports, all athletes participating in any sport should comply with its respective return-to-play guidelines.¹¹

In general, physical contact with another athlete was known as the most frequent cause of injury, followed by noncontact trauma and overuse.¹⁰ However, the injuries for Korean athletes during OGs were caused by overuse (41.6%) and noncontact (25.6%). These differences seem to be closely related to the number of participants in contact sports. The number of Korean athletes participated in noncontact sports were relatively much more than that in contact sports. Because the causes of injury differed substantially among sports, injury prevention programs should be customized to the injury profile of the each sport.

Illness risk during the Olympics

Illnesses incurred during competitions and training can affect an athlete’s performance, just like an injury.¹¹ The illnesses incidence of KOT in Rio OGs was 35.8 illnesses per 100 athletes, which is even higher than that of in Vancouver (7.21 illnesses per 100 athletes), London (7.17 illnesses per 100 athletes), and Sochi (8.9 illnesses per 100 athletes).^5,6,11 This is also related to a small size of the study cohort that can influence prevalence rates.³¹ The frequency of illnesses in women (33.7%) was higher than in men (14.6%), which coincided with the results of epidemiologic studies during the London and the Vancouver OGs.^5,11 Also, most of infections were occurred in respiratory tract (75.9%) just like the results in other multi-sports events.^5,6,11,31 A previous study mentioned that the athletes’ respiratory infections were caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents.³² A preventive strategies of respiratory infections in elite athletes could be established.

Data-collection procedures

Because small changes of injury and illness occurrence are exaggerated in prevalence rates,³¹ all Korean medical staff were required to collect an accurate and precise data on injuries and illnesses. Therefore, they documented all athlete interactions including taping, strapping, and basic wound care and send it the person in data management via e-mail daily. In case of Football, Golf, and Sailings which were always not in Olympic Village, an athletic trainer of each event also was required to record detailed information on injuries and illnesses and send it via e-mail daily. In doing so, the perfect compliance on all injuries and illnesses occurred during Rio OGs was done.

Practical application and further research

The first step is to analyze risk for injury and illness in a specific population of athletes to develop effective prevention strategies.⁴ The next subsequent step is to identify the most common injury mechanisms and related risk factors.³³ To our knowledge, this is the first study to collect the prospective data among Korean athletes in the OGs. This provides a unique sporting competitive environment, which is valuable information on the injuries and illnesses suffered by high performance athletes at the top of competitive event of their sporting careers. This implies that unique characteristics of Korean elite athletes’ injury and/or illness were identified and based on this information, Korean athlete-specific prevention strategies of injury and/or illness could be developed. It is known that greater exposure to the environment of risk can increase the number of injury and illness³¹ but this study did not logistically record the amount of exposures to training and competitions for Korean athletes during OGs by sport event. Further studies should include a record of the number of exposures to training and competition, for determining the true risk of injuries, and it would help to identify more accurate rate and risk of injury and/or illness by sport event.

Conclusion

To our knowledge, this is the first study that evaluated the incidence and frequencies of injuries and illnesses in Korean elite athletes in the Rio 2016 OGs. Around 56.3% of the athletes suffered from an injury and 24.0% from an illness during the Rio OGs. The incidence rate of injuries and illnesses varied substantially among sports. The highest rate of injury was in boxing, wrestling, and taekwondo, whereas the highest rate of illness was in boxing, swimming, and fencing. Mechanism of injury and associated risk factors in Olympic sports should be analyzed in future studies to develop effective preventive strategies for Korean elite sport athletes.

Footnotes

Acknowledgements

All authors highly appreciate the cooperation of all medical staff of Korean Olympic team contributing to the data collection. The authors also like to thank all participating athletes.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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